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Cervical Traction for Neck Pain

18 Nov

In addition to spinal manipulation, doctors of chiropractic often use other conservative therapies to reduce pain and improve function in patients with neck pain. When it comes to neck conditions involving herniated disks, radiating arm pain (“radiculopathy”), strains, facet syndromes or sprains, and myofascial pain, cervical traction is one such option.

As part of the initial new patient examination, a chiropractor may use their hands to gently pull on the patient’s neck while in sitting and/or supine (lying on the back) positions. If this feels good, then cervical traction may be warranted either in the office, with an at-home unit, or both. However, cervical traction is not advised if there is instability in the spine/ligaments, vertebral artery insufficiency, rheumatoid arthritis, osteomyelitis, discitis, neoplasm, severe osteoporosis, untreated hypertension, severe anxiety, cauda equina syndrome, or myelopathy.

There are various forms of cervical traction devices, so treatment may be performed while the patient is in a standing, sitting, lying horizontal, or inclined either prone or supine position, and the traction force can be continuous or sustained vs. intermittent or pulsed. Variables include body/head weight and the associated friction against the traction table in lying down types of units, and the angle can often be varied with most types of traction units.

There are pros and cons to different types of traction units. Lying down traction may allow for better relaxation vs. sitting, but more weight may be needed due to the friction of the body on the table. Generally, when hold times are longer (especially with sustained traction), less weight is used. Some doctors advocate starting at 5 lbs. (~2.67 kg) for 15 minutes with a sitting device (sustained traction) and gradually increasing the weight to maximum tolerance while keeping the time constant at 15 minutes.

There are a number of theories on why traction relieves pain: it forces rest through immobilization and by supporting the weight of the head, it pulls apart or opens the facet joints, it improves nutrition to the joint cartilage, stretches ligaments, it decreases the pressure inside the disks, it reduces pressure on nerve roots (by widening the holes through which they travel), it improves head posture, and/or it stretches the neck muscles to improve blood flow and reduce muscle spasm.

The bottom line, if you have neck pain and manual traction applied to the cervical spine provides pain relief, then your doctor of chiropractic may choose to incorporate this therapy into your treatment plan, either in the office, at home, or both.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Do Cell Phones Cause Horns?

21 Oct

It’s not hard to argue that nearly everyone spends too much time on their electronic devices, especially smartphones. You may be familiar with the terms “text neck” or “forward head posture”, but have you heard that excessive cellphone use may cause your body to grow horns?

If you reach around to the back of your head, just above the top of the neck, you should feel a bump in the midline. This is NORMAL, and it’s called the external occipital protuberance (EOP). The EOP serves as an attachment point for the nuchal ligament and the trapezius muscle, which function to keep the head upright and tilted backward. The size of the EOP normally varies (averaging around 5mm), depending on race, gender, genetics, and occupation.

A 2016 study revealed that an alarming number of young people had spurs (technically called enthesophytes) extending from the EOP, an occurrence associated with the wear-and-tear of osteoarthritis that can develop later in life. In the study, researchers reviewed x-rays of 218 men and women 18 to 30 years old who either had back pain, neck pain, or headaches or no history of such conditions. The research team observed an enlarged EOP (EEOP for short) in 41% of participants, regardless of the presence or absence of musculoskeletal pain. However, the data did show that EEOP was three-times more common in men than women.

The same study authors conducted a larger study in 2018 that included 1,200 adults of all ages and found that the combination of male gender, the degree of forward head protraction (FHP), and age predicted the presence of EEOP. Their results showed that being a young male with a greater amount of FHP lead to the formation of EEOP.

The researchers suspect that the age component of their finding (after all, the frequency and severity of degenerative skeletal spur formation typically worsen with age) may be due to young adults placing a greater mechanical load on their necks due to forward head posture caused by excessive device use.

The good news is that studies have demonstrated forward head posture can be improved with specific resistance and stretching exercises, monitoring your posture while using electronic devices, and reducing electronic device use. Your doctor of chiropractic can show you exercises that you can perform at home to reduce forward head posture.

 

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Exercise and Posture Training for Neck Pain

16 Sep

A quick look around any airport, mall, or auditorium/theater will reveal that poor posture is common. There’s forward head posture, rolled forward shoulders, and uneven/misaligned heads/shoulders/pelvis-hips. Some people even limp or shuffle while walking. Research shows that when a person adopts an abnormal posture, it can place added strain on various areas of the body, which can elevate the risk for musculoskeletal pain, including neck pain. The good news is that when combined with chiropractic care, at-home exercises are great for improving a patient’s posture, which can also reduce their risk for future episodes of neck pain. Let’s look at some of the studies that support the use of at-home exercise and posture training for neck pain…

  • For older adults with a bent forward posture due to rounding of the mid back (“hyper kyphosis”), a six-month study that included 99 seniors revealed that a one-hour, three times a week exercise program resulted in both improved spinal curvature and self-esteem.
  • Among two groups of young adults with rounded shoulder posture, researchers found that shoulder stabilization and shoulder stretching exercises (40 mins, three times a week for four weeks) benefited patients in different ways. This suggests that combining these exercises may be the best approach to improve balance, strength, flexibility, and posture.
  • In another study that included young adults with rounded shoulder posture, researchers reported that patients experienced better results when scapular stabilization exercises were combined with abdominal bracing exercises.
  • Teenagers with forward head and protracted shoulder posture exhibited improved posture when specific neck and shoulder exercises were incorporated into their physical education program for sixteen weeks.

In 2008, the Neck Pain Task Force recommended exercise for the management of neck pain, including neck pain associated with a whiplash injury. A 2016 literature review published in the journal Spine added to that recommendation by noting that exercise is also effective for grade III whiplash and neck pain (and injury that includes loss of neurological function). Interestingly, the review did not find one form of exercise to be superior to another, suggesting that combining several forms of exercise may be the best way to achieve the most satisfying outcome for the patient.

Doctors of chiropractic are highly skilled in manual therapies, exercise training, and functional assessments – all of which have been found to successfully improve outcomes for patients with persistent neck pain. As with most conditions, prompt treatment yields the best results, so don’t delay in starting your chiropractic management program!

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Chiropractic Treatment for Wry Neck

19 Aug

Wry neck, also known as torticollis, is a painful condition in which the top of the head usually tilts to one side while the chin rotates to the opposite side. Torticollis can have several causes from infection (cold, flu, or otitis media, for example) to sleeping in a draft; however, the cause is usually unknown (idiopathic).

In a typical case, torticollis may resolve itself within four to six weeks, but with chiropractic care, cervical function can return to a more normal state much faster, often within a week. Chiropractic treatment for torticollis often includes stretching, in which manual cervical traction, spinal mobilization, and myofascial release techniques help to restore the lost range of motion and faulty posture. Once enough motion has been restored, a doctor of chiropractic may utilize spinal manipulation, which often hastens the recovery rate of torticollis. Chiropractors may also use physical therapy modalities and/or provide instruction on home-based exercises and other self-management strategies.

There’s a type of torticollis called congenital torticollis in which an infant is born with torticollis that either developed in utero or during the birth process. Current guidelines support prompt treatment for congenital torticollis versus taking a wait-and-see approach. One study found that treating infants with gentle manual therapy approaches at one month of age led to higher success rates than waiting until they were six months or older when substantially more care was needed to restore full range of motion with lower odds of success.

There is a less common but more serious type of torticollis called cervical dystonia, sometimes referred to as spasmodic torticollis, which is characterized by involuntary contraction of muscles in the neck that twist the head in a variety of directions. Cervical dystonia can occur at any age, but it’s more common among middle-aged women. While there is no known cure for the condition, there are case studies showing that cervical dystonia may respond to chiropractic treatment. In one such case study, a 59-year-old woman with an eleven-year history of cervical dystonia experienced a dramatic improvement in function (from 3/10 to 9/10 on a scale of 0 to 10, 10 being full function and 0 being no function) following a treatment regimen that included cervical spinal manipulation, reflex therapy, eye exercises, and vibration therapy.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Migraine Headaches and Nutrition Approaches

15 Jul

People with migraines know all too well about that throbbing, pulsating, and nauseated feeling that accompanies their headaches and the associated disability that often results. The underlying cause of migraine headaches is still not well understood, but genetics (family history), chemical imbalances in the brain (serotonin, in particular), environmental factors (weather, allergens), and hormonal changes appear to play a part. Because medications to manage headaches can come with potentially serious side effects, especially with prolonged use, many patients opt for non-pharmaceutical treatment approaches to reduce the frequency and intensity of their migraines…

A 2018 survey of 4,356 American adults with a history of migraines found that common symptoms associated with migraines include sensitivity to touch (32%), food cravings (28%), and hallucinations (18%), which include sound and smell. The most common foods to trigger a migraine were chocolate at 75%, cheese (especially aged cheeses) at 48%, citrus fruit at 30%, and alcohol (especially red wine) at 25%. Other foods that may be triggers include cured meats, monosodium glutamate (MSG), aspartame (and other artificial sweeteners), snack foods, fatty foods, dairy products, food dyes, coffee, tea, cola, and nuts.

According to a 2019 study, people who suffer from migraines are often deficient in magnesium (Mg), a mineral naturally found in spinach, nuts, and whole grains. Magnesium is also important in regulating blood pressure, blood sugar (glucose), and muscle and nerve function. A meta-review of previous study findings revealed that migraine patients who received a Mg supplement reported reductions in both headache frequency and intensity. Other benefits included a decrease in hospitalization during pregnancy, and at a higher dose, a lower incidence of type-2 diabetes and stroke!

Another nutritional anti-migraine option includes the use of fever few (Tanacetum parthenium) for both prevention and treatment of migraine headaches. Other benefits of fever few include fever reduction, irregular menstrual cycles, arthritis, psoriasis, allergies, asthma, tinnitus, dizziness, and nausea/vomiting. There is also research support for the use of riboflavin (vitamin B-2), melatonin and coenzyme Q10 by migraine patients.

Doctors of chiropractic often manage their migraine headache patients using a multi-modal approach that includes cervical spinal manipulation and mobilization, physical therapy modalities, home exercise training, nutritional counselling (including supplementation advice), and other conservative treatment approaches based on the patient’s specific needs.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Neck-Specific Exercise for Headaches & Neck Pain

13 Jun

As screens (televisions, computers, and smartphones/tablets) become an increasingly important part of daily life, many people gradually take on a more slumped posture, which can place added strain on the neck and shoulders, raising the risk for neck pain and headaches. Luckily, it’s possible to improve forward head posture, rounded shoulder posture, and scapular instability with neck-specific exercises and chiropractic care.

In a 2018 study, patients with forward head posture performed either scapular stabilization or neck stabilization exercises for 30 minutes three times a week for four weeks. Participants in both groups experienced improvements related to their craniocervical angle and muscle activity around the upper back and neck, with greater results reported by the scapular stabilization group.

Several studies have shown similar results for improving forward head posture using both scapular and neck stabilization exercises. In another study, high schoolers with forward head posture performed scapular and neck stabilization exercises and exhibited good posture up to four months later.

A 2019 study looked at the effect of a six-week intervention featuring manual therapy and/or stabilizing exercises on 60 women with neck pain and forward head posture. Participants in both the manual therapy/stabilization exercise-combo group and the stabilization exercises-only group reported better outcomes with respect to head posture, pain reduction, and improved function, but the results were best in the combined treatment group. The authors concluded that manual therapy adds a meaningful role to a structured exercise program that addresses scapular and neck instability and forward head and rounded shoulder posture.

Doctors of chiropractic often incorporate exercise training in their treatment recommendations, especially when postural issues may contribute to the patient’s symptoms, like neck pain and headaches.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.